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      Effect of ridge preservation at molar extraction sites with severe periodontitis on the Schneiderian membrane thickness changes: a pilot study

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          Abstract

          Background

          Information regarding the reaction of bone augmentation in terms to sinus mucosa thickness of periodontally compromised molar extraction sites is limited. This retrospective study aimed to analyze the effect of ridge preservation procedures following the extraction of molars with severe periodontitis on the healing pattern of adjacent maxillary sinus mucosal membranes.

          Methods

          Thirty-one periodontally compromised maxillary molar teeth either receiving ridge preservation (test group, n = 20) or undergoing spontaneous healing (control group, n = 11) were investigated. Cone-beam computed tomography (CBCT) scanning was performed before the extraction procedure and repeated 6 months later. The mucosa thickness (MT) of the adjacent periodontally compromised molar tooth was measured from CBCT images before tooth extraction and after 6 months of healing at nine assigned measurement points. The data were analyzed at α = 0.05.

          Results

          The prevalence of pre-extraction maxillary sinus mucosal thickening was 60.0% and 63.6% in the test and control groups, respectively. The average MT of the thickened sinus mucosa before tooth extraction was 3.78 ± 2.36 mm in the test group and 4.63 ± 3.20 mm in the control group ( P = 0.063). The mean mucosal thickening reductions in the thickened MT subjects after 6 months of healing were 2.20 ± 2.05 mm (test group) and 2.64 ± 2.70 mm (control group), P = 0.289. The differences of MT between the time prior to extraction and after 6 months of healing were statistically significant within both groups ( P < 0.05).

          Conclusions

          Following extraction of molars with severe periodontitis, a reduction in swelling of the Schneiderian membrane has been observed regardless of the addition of a DBBM socket graft. However, a mucosal thickness > 2 mm was still frequently observed.

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          Most cited references33

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          Evidence-based knowledge on the biology and treatment of extraction sockets.

          The fresh extraction socket in the alveolar ridge represents a special challenge in everyday clinical practice. Maintenance of the hard and soft tissue envelope and a stable ridge volume were considered important aims to allow simplifying subsequent treatments and optimizing their outcomes in particular, when implants are planned to be placed. Prior to the consensus meeting four comprehensive systematic reviews were written on two topics regarding ridge alteration and ridge preservation following tooth extraction and implant placement following tooth extraction. During the conference these manuscripts were discussed and accepted thereafter. Finally, consensus statements and recommendations were formulated. The systematic reviews demonstrated that the alveolar ridge undergoes a mean horizontal reduction in width of 3.8 mm and a mean vertical reduction in height of 1.24 mm within 6 months after tooth extraction. The techniques aimed at ridge preservation encompassed two different approaches: i) maintaining the ridge profile, ii) enlarging the ridge profile. Regarding timing of implant placement the literature showed that immediate implant placement leads to high implant survival rates. This procedure is primarily recommended in premolar sites with low esthetic importance and favorable anatomy. In the esthetic zone, however, a high risk for mucosal recession was reported. Hence, it should only be used in stringently selected situations with lower risks and only by experienced clinicians. In molar sites a high need for soft and hard tissue augmentation was identified. Future research should clearly identify the clinical and patient benefits resulting from ridge preservation compared with traditional procedures. In addition, future research should also aim at better identifying parameters critical for positive treatment outcomes with immediate implants. The result of this procedure should be compared to early and late implant placement. © 2011 John Wiley & Sons A/S.
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            Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study.

            This study evaluated the pathologic and spatial associations between apical periodontitis of the maxillary premolars/molars and the maxillary sinus mucosal thickening using cone-beam computed tomography (CBCT) scanning. CBCT images of 372 patients with 508 exposed maxillary sinuses were inspected retrospectively. Clinical features such as sex and age of the patients and pathologic findings of the maxillary sinus and adjacent teeth were recorded, graded, and analyzed. Maxillary sinus mucosal thickening was found in 180 (48.4%) patients and 235 (46.2%) sinuses. The prevalence of maxillary sinus mucosal thickening increased dramatically as the severity of apical periodontitis increased (from 41.5% in those without periodontal disease to 100%). However, the nature of the spatial relationship between the maxillary sinus floor and the infected root tips or between the sinus floor and periapical lesions did not appear to have an effect on the prevalence of maxillary sinus mucosal thickening. Patients over 60 years of age had the highest prevalence of maxillary sinus mucosal thickening. A retrospective inspection of CBCT images revealed that the prevalence and severity of maxillary sinus mucosal thickening were positively associated with the degree of apical periodontitis. CBCT imaging is applicable for the evaluation of the maxillary sinuses and adjacent teeth. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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              Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey.

              Mucosal thickening and mucosal antral cyst (MAC) in the maxillary sinus are incidental findings in panoramic radiographs. The study sample consisted of 5021 participants in a nationally representative Health 2000 Health Examination Survey using panoramic radiography. The prevalence of mucosal thickening was 12% and of MACs 7%, both being twice as frequent in men as in women. Mucosal thickening was most common in the 40- to 49-year age group, whereas MACs were most often seen in younger age groups. Pathologic dental findings and root canal treatments were significantly associated with mucosal thickening but not with MACs. The odds ratios of vertical infrabony pockets were 5.2-fold compared with edentulous. This nationally representative study indicates that dental infections are etiologic for antral mucosal thickening, but not for MACs. Copyright 2010 Mosby, Inc. All rights reserved.
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                Author and article information

                Contributors
                huwenjie@pkuss.bjmu.edu.cn
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                12 April 2021
                12 April 2021
                2021
                : 21
                : 184
                Affiliations
                [1 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, , Beijing Key Laboratory of Digital Stomatology, ; 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081 People’s Republic of China
                [2 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Stomatology, Beijing Friendship Hospital, , Capital Medical University, ; Beijing, People’s Republic of China
                [3 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Emergency, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, , Beijing Key Laboratory of Digital Stomatology, ; Beijing, People’s Republic of China
                [4 ]GRID grid.34477.33, ISNI 0000000122986657, Department of Restorative Dentistry, , University of Washington, ; Seattle, WA USA
                Article
                1546
                10.1186/s12903-021-01546-8
                8040225
                c14c9cbb-7505-48c1-8526-c6583a3b5203
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 31 October 2020
                : 30 March 2021
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Dentistry
                bone grafting,cone-beam computed tomography,mucosal thickening,tooth extraction,periodontitis

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